Research has shown that assisting new graduates make an effective transition to practice can help decrease staff turnover, increasing the quality of care provided to residents.

DADS Quality Monitoring Program has collaborated with the Texas Association of Vocational Nurse Educators (TAVNE), the Texas Health Care Association (THCA), and TMF-Quality Improvement Organization (TMF-QIO) to develop an educational toolkit that can be used by Vocational Nurse (VN) Educators and nursing facilities to assist new LVNs as they transition from the classroom to practice. The material in this toolkit can be used by VN Educators to enrich their curriculum, and is meant to be an additional resource for best practice.

The supplemental resources in the toolkit can assist VN Educators as they prepare their students for the transition to practice. In the nursing home, the DON/ADON may use this material to assist new LVNs transition to the long-term care setting. New modules and updates to existing modules will be added over time.

About the Toolkit

Vocational nurse educators are encouraged to use this information to enhance students' knowledge of long-term care.

Directors of nursing are encouraged to use this material with new LVNs to help with transitioning them to working in a long-term care facility.

Module 1: Abuse, Neglect, and Exploitation (ANE)

Every year, around 4 million older Americans are the victims of some form of abuse, neglect or exploitation (ANE). For every case reported to authorities, experts estimate as many as 23 cases go undetected. Nurses must be able to recognize the clinical indicators of ANE and need to know what actions to take if ANE is suspected. The Abuse, Neglect and Exploitation module was developed as an additional resource for VN Educators and nursing homes as they prepare new LVNs for the transition from student to practice.

Module 2: Medication Administration

FDA studies show that medication errors injure about 1.3 million people in the United States each year and cause the death of 7,000. Safe medication administration is essential to nursing practice, and nurses must have knowledge and skill in the techniques of administering all pharmaceutical agents. The Medication Administration module was developed as an additional resource for VN Educators and nursing homes as they prepare new LVNs for the transition from student to practice.

Links to Texas Board of Nursing Rules and Regulations, the Texas Administrative Code and Federal regulations related to medication administration

Links to videos regarding the severity of medication errors and ways to keep them from occurring

Case studies and other learning activities

Links to the Institute for Safe Medication Practices, the US Food and Drug Administration and the University of Iowa Geriatric Education Center

Module 3: Assessment

Assessment is a key component of nursing practice, required for planning and the provision of resident and family centered care. Information that is obtained from an accurate assessment serves as the foundation for age-appropriate nursing care, enhancing the residents' quality of life and independence. The Assessment module will provide you with all of the information necessary to ensure adequate assessments are completed for each resident in the facility.

Booklets and leaflets developed by the Alzheimer's Association and the Behavior Management Task Force, designed to help the LVN provide person-centered care to nursing home residents.

Case scenarios and other learning activities

Examples of alternative communication devices

Module 4: Alzheimer's Disease and Dementia

Dementia is an ‘umbrella’ term for a wide range of symptoms associated with a decline in mental ability severe enough to interfere with daily life. The most common type of dementia is Alzheimer's disease, accounting for 60-80% of cases; one in nine Americans aged 65 or older has Alzheimer's disease. Vascular dementia, which generally occurs after a stroke, is the second most common type. This module was developed to provide the LVN student with additional information related to the disease process as well as the resources that are available to care for individuals and their families.

Module 5: Documentation

Documentation is a process of reporting and recording used by health-care practitioners that helps them direct resident care. Documentation is a professional responsibility of all health-care practitioners, providing written evidence of the practitioner's accountability to the resident, the institution, the profession and society.

The Documentation module was developed as an additional resource for VN Educators and nursing homes as they prepare new LVNs for the transition from student to practice.

Module 6: Time Management

Time Management refers to the way that the LVN organizes specific activities and determines how much time will be spent on those activities. The Time Management module will provide the LVN with tips for effectively managing one's time, barriers that may be faced and methods for working through those barriers.

Module 7: Transition to Practice

Newly graduated nurses have neither the practice expertise nor the confidence to navigate what has become a highly dynamic and intense clinical environment burdened by escalating levels of patient acuity and nursing workload. The Transition to Practice module is designed to assist newly graduated LVNs on their journey as they progress through at least the first year of practice, gaining the confidence and competence necessary to continue in the field.

Model 8: Retention

Staff who are familiar with a nursing facility's resident's routines and practices are likely to provide better care and are more likely to develop bonds with the residents and with other staff. There is a relationship between nursing facility staff turnover and quality problems, resulting in adverse outcomes. This module will cover topics that directly link to the retention of staff in all areas of nursing, but more specifically in long-term care.

Module 9: Success in the Workplace

Providing nursing care to individuals is just one aspect of the day-to-day job that the LVN will take on. The LVN also assumes additional roles, including advocate or mediator, and may often feel like a housekeeper, waitress, and technology expert. Having a solid support system is critical to the LVN's success in his/her new position. This module was developed to assist the new LVN in navigating the dynamic and intense clinical environment in which he or she will be working.

Module 10: Collaboration with the RN

In nursing, there are three distinct levels of nursing, the Licensed Vocational Nurse (LVN), the Registered Nurse (RN), and the Advanced Practice Registered Nurse (APRN), each with a different scope of practice. This module will discuss the expectations the LVN should have with regards to support and assistance from the RN.

Information about the differing scopes of practice for APRNs, RNs and LVNs

Roles and responsibilities of the RN in a nursing facility

Explanations of the different types of assessment and which are within the LVN's scope of practice

Module 11: Ethics

Individuals often relate ethics to their feelings; however, in nursing, ethical behavior goes far beyond one's feelings and into doing what is right for all of those involved. In this module, the LVN will not only learn what ethics is, but he/she will learn about the Code of Ethics that have been developed by the American Nurses Association (ANA) to guide the LVN's everyday practice and ensure safety and security for the individuals for whom the LVN provides care.